Health Care and Shutdown Debacles are Mere Symptoms

Many reporters caught up in the bizarre world of official Washington have written extensively on political tactics and implications of the so-called government shutdown and disastrous launch of HealthCare.gov. Typical was a New York Times headline that blared “Republicans, Sensing Weakness in Health Law Rollout, Switch Tactics.”

But there’s been precious little analysis about the underlying realities that led us to this point. Perhaps that’s because neither political party wants to face up to those realities. So, instead of substance, D.C. journalists cover politics like junior high school students trying to keep up with who’s in, who’s out, and who likes who.

Admittedly, dealing with reality is hard. But ignoring it is even worse.

For example, many problems with the HealthCare.gov website can be traced directly to a problem with the law itself, not the computer coding. Reports indicate that government officials directed the site designers to require people to sign up first before being able to explore pricing options. Later, when an upfront way to get pricing information was added, it was structured to deliberately understate the actual costs for most people.

No private business would attract customers this way, but it was not a programming glitch. The real problem is that the prices for insurance offered under the “Affordable Care Act” guidelines are just too high to attract consumers. The political challenge was how to cover up this reality.

The disconnect can be seen in the president’s sales pitch as well. He points out, correctly, that young healthy Americans should have health insurance because one unforeseen accident could wipe them out financially. However, that’s an argument for a relatively inexpensive major medical policy that covers only the big expenses. Unfortunately, the president’s law does not allow them to buy such a policy.

This is a problem that computer programmers can’t solve. It’s not the website that’s broken, it’s the law. Until consumers are empowered to make their own health care spending decisions, the problems will remain.

A similar problem can be found with Republican efforts to reduce federal spending.

For four decades, official government accounting policies have been designed to hide the growth of government spending. Famously, Congress has decreed that a reduction in planned spending growth should be deemed a spending cut. On top of that, Congress has deemed some spending “uncontrollable,” a category that now includes a majority of the federal budget.

The underlying reality that neither political party wants to address is that three programs account for roughly 60 percent of the federal budget. Those programs are Social Security, National Security and Medicare, and they include automatic spending increases every single year. There is simply no way to reduce government spending without addressing these three budget items. And if long-term fixes are not implemented, there is no way taxes can be raised enough to cover the spending.

These are the challenges our elected politicians prefer to avoid: finding a way to put consumers in charge of health care choices and reforming the three programs that drive federal spending.

Their failure to address these realities is the reason we are stuck with petty partisan bickering over shutdowns and websites.